Veterinary Clinics of North America. Small Animal Practice

Primary renal tumors are an uncommon diagnosis in small animals. Presentation, treatment, and prognosis depend on tumor type. Surgery with or without chemotherapy are the mainstays of treatment. Transitional cell carcinoma is the most common tumor of the urinary system. Clinical signs include hematuria, stranguria, and pollakiuria. Metastatic disease can develop over time within medial iliac lymph nodes, lungs, and vertebrae. Treatment of transitional cell carcinoma centers on chemotherapy with mitoxantrone, vinblastine, or carboplatin...

Urinary tract imaging is an important part of the diagnostic work-up in patients with urinary diseases. Multiple modalities are available, and this article provides an overview of the different modalities, techniques, and indications.

Stem cell therapy has tremendous potential for clinical application in the treatment of a variety of diseases in veterinary medicine. Based on the known desirable immunomodulatory properties of mesenchymal stem cells, this therapy has potential for treatment of a variety of renal diseases. This review details our current understanding of stem cell biology and proposed mechanism of action as applicable to renal disease. Studies performed in chronic kidney disease clinical trials and models of acute kidney injury are summarized with the goal of providing an overview of the current status of this treatment modality and its potential for the future...

A complete urinalysis is an essential diagnostic test to perform in veterinary patients. When interpreted in the context of a patient's clinical history, physical examination findings, and other diagnostic test results, a urine specific gravity, chemical analysis (often via semiquantitative dipstrip testing), and sediment examination are vital to detect both renal and nonrenal disorders. In this article, we describe the usefulness of each component of a urinalysis, the significance of and how to interpret results, and common causes of false-negative and false-positive results...

"Urinary tract infection (UTI) is a common diagnosis in companion animal practice and is responsible for a significant proportion of antimicrobial use in veterinary medicine. The veterinary community has begun to follow the standards of care in human medicine and shift its definition of an UTI based on culture results and toward the presence of lower urinary tract symptoms. An improved understanding of the pathophysiology of UTI, risk factors for clinical disease, and the implementation of more reliable in-house diagnostic testing can lead to improved outcomes for patients and reduce inappropriate treatment...

Untreated house soiling presents a severe risk to the human-animal bond. Despite being one of the most common behavior problems reported to veterinarians, a majority of veterinarians surveyed reported a lack of confidence in their ability to diagnose nonmedical inappropriate elimination. Successful resolution depends on an appropriate diagnosis, which is arrived at by a thorough medical and behavioral history, once medical problems have been ruled out. A systematic approach to collecting history, noting clinical signs and ruling out differentials, is most likely to yield positive results in the shortest time...

Cytologic evaluation of the urinary tract can be diagnostically rewarding in cases of renomegaly or when discrete kidney or bladder masses are identified. Cytology can often help to distinguish between cystic, inflammatory, and neoplastic disorders. Various types of cystic and benign urinary tract lesions, diseases associated with urinary tract inflammation, and the cytologic differences between primary and metastatic neoplasms of the kidney and bladder are described. Basic sampling techniques for urinary tract cytology are also discussed...

Minimally invasive interventional therapies are the new standard of care in veterinary medicine. In comparison with standard surgical procedures, they are associated with minimal tissue injury, leading to shorter, smoother recovery and decreasing the perioperative morbidity and mortality. A thorough understanding of the therapeutic options available is essential to properly educate and inform clients. Proper equipment, technical expertise, and experience are essential prerequisites to many of these procedures...

Dietary management of urolithiasis in dogs and cats is designed to dissolve calculi when possible and/or reduce the risk of recurrence. The diet must reduce urine relative supersaturation for the particular salt in order to prevent crystallization. To decrease urinary concentrations of crystal precursors, increasing water intake is essential regardless of the stone type. Altering the amounts of dietary precursors of the stone and controlling urine pH is mostly effective for struvite, urate, xanthine, and cystine, but still subject to controversy for calcium oxalate...

Canine acute eosinophilic dermatitis with edema is an uncommon syndromic disorder in dogs with a unique clinical presentation. Most but not all dogs have a history of gastrointestinal upset preceding or concomitant with skin lesion onset. Affected dogs present with macular to generalized erythema that is most evident on the glabrous skin of the abdomen. Although the etiology is not known, an adverse drug reaction or a systemic type I hypersensitivity reaction may play a role. Some cases can be difficult to distinguish from canine sterile neutrophilic dermatosis due to overlapping clinical criteria and eosinophil degranulation in tissue section...

Canine sterile pyogranulomatous dermatitis and panniculitis is an infrequently described syndrome. No autoantigen, or exogenous antigen, inflammatory stimulus has been identified. This syndrome is characterized by pyogranulomatous nodules, plaques, and ulcers of variable extent and severity. Prodromal and concurrent nonspecific clinical and hematologic signs of inflammation may occur. This waxing and waning condition is typically responsive to systemic immunomodulation. Lifelong therapy may be required to prevent relapse...

Canine atopic dermatitis (AD) is one of the most common inflammatory skin diseases in dogs. The pathogenesis is complex and not completely understood. Many therapeutic options are available; however, because of cost, side effects, or a long lag phase, new compounds are constantly produced. This article provides a comprehensive review of the latest compounds for the treatment of canine AD. In addition, a brief review of new studies on conventional medications is provided. For a successful long-term therapeutic approach, it is important to considerate the status of the disease, as well as the patients' and their owners' needs...

Cutaneous lymphomas are divided into categories based on histologic evaluation of the skin and location of neoplastic lymphocytes. Epitheliotropic cutaneous lymphoma, also known as cutaneous T-cell lymphoma, is diagnosed when neoplastic lymphocytes show tropism for the epidermis and these cells infiltrate the epidermis and adnexae. In diagnosis of nonepitheliotropic cutaneous lymphoma, neoplastic lymphocytes are found mostly in the dermis and/or subcutis. Neoplastic cells are of either B-cell or T-cell origin...

Feline pemphigus foliaceus is an uncommon skin disorder in cats but still the most common autoimmune skin disorder seen in this species. It is a crusting dermatosis involving the ears, head, paws, and ungual folds primarily. Although cytology is helpful in supporting a diagnosis, biopsy of pustules or crusts for histopathology is required for a definitive diagnosis. Therapy has evolved over the years as we have learned more about the different ways cats respond to drugs and as new drugs became available. Most cats will respond to proper therapy, although it may be needed long term for control...

As the spectrum of canine cutaneous lupus erythematosus (CLE) variants has expanded markedly in the recent 2 decades, veterinarians are encouraged to become familiar with the characteristic clinical features of CLE variants to permit early diagnosis and appropriate treatment. This article describes the signalment, clinical signs, treatment outcome, and laboratory and histopathology findings of 2 new canine CLE variants, generalized discoid lupus erythematosus and mucocutaneous lupus erythematosus.

Allergen immunotherapy has been used for many years in dogs and cats and is the only specific treatment of atopic dermatitis that changes the patho-mechanisms of disease by stimulating allergen tolerance. Subcutaneous administration of allergens is the most commonly used administration route, typically in increasing concentrations (induction period) followed by long-term injection of allergen extract (maintenance therapy). Rush protocols with an abbreviated induction period have been reported and shown to be safe in dogs...

Canine perianal fistulas are painful sinus tracts and ulcers that spontaneously develop in the skin around the anus. Middle-aged German shepherd dogs are most commonly affected and may have a genetic susceptibility. Although the disease was once believed related to conformational factors and primarily managed surgically, an immune-mediated pathogenesis is now recognized. Long-term medical management with immunomodulatory agents has become standard of care for canine perianal fistulas. Perianal fistulas can be debilitating and have a negative impact on quality of life of dogs and owners...